Case 5 : Vaccination Under the Midnight Sun: Validation of an Immunization Registry in the Northwest Territories

With the implementation of mandatory reporting of all immunizations in the Northwest Territories (NWT) in 2012, the Department of Health and Social Services’ (DHSS) Disease Registry Unit was working toward the implementation of a new immunization registry similar to those implemented across the country. However, the current immunization registry was in the format of an Excel workbook. The DHSS noticed several issues with the quality of the data maintained in the spreadsheets. As part of Janet’s practicum, she conducted an audit of the immunizations for the cohort of children born between 2012 and 2014, inclusive, within the registry. Community health centres are required to submit immunizations they have administered via a monthly spreadsheet. The Disease Registry team then validates and cleans the information submitted and consolidates all the data into the immunization registry on one master Excel workbook. It is important to note that the original data submitted to the DHSS from the health centres is only added to the immunization registry after the Disease Registries Officer has confirmed that the data are clean. To assess the validity and reliability of the data, the community health centres were contacted and asked to submit all paper immunization records for children in this cohort, which were then entered into another spreadsheet. The cohort spreadsheet and the immunization registry were compared to determine the number of errors across various variables. To summarize, the audit was a comparison of the original community spreadsheet submitted to the DHSS with the paper immunization cards, which Janet entered into a separate spreadsheet to easily compare the two datasets

Proving Our Maternal and Scholarly Worth: A Collaborative Autoethnographic Textual and Visual Storying of MotherScholar Identity Work during the COVID-19 Pandemic

Pivoting to remote work as female academics and to schooling our children from home as mothers in March 2020 marked a dramatic shift in how we enact our MotherScholar identities. This collaborative autoethnographic study employs a modification of interactive interviewing and photovoice to produce verbal and visual text of COVID-19 MotherScholar identity work for analysis. Thematic analysis results in themes of maternal interruptions, professional interruptions, maternal recognition, and professional recognition. Of note, our MotherScholar interactivity functioned as identity work as we sought and granted legitimacy to one another’s’ COVID-19 MotherScholar identities. Of particular concern to us is how institutions of higher education are (dis)enabling socially supportive MotherScholar interactivity during COVID-19 conditions that persist at the time of this writing and how they intend to address social support needs sustainably into the future

Improving access, quality and safety of caesarean section services in underserved rural Tanzania: The impact of knowledge translation strategies

This research was designed to study different approaches to improve access to, and quality of caesarean section services in underserved Tanzania and translate evidence into practice. In 2016, 42 associate clinicians from five health centers were trained in teams for three months in comprehensive emergency obstetric and neonatal care and anesthesia followed by post-training supportive supervision and mentorship. From 2016-2019, 2,179 caesarean sections were performed in the intervention and 969 in the control health centers. Catchment population-based caesarean section rates increased significantly in all five intervention health centers and were more than 10% in three facilities. The risk of a woman dying from complications of caesarean section in the intervention health centers was 2.3 per 1,000 caesarean sections (95% CI 0.7 - 5.3). This educational program was adopted by the government and can be used to meet the demand for caesarean section services in other underserved areas in Africa.   Cette recherche a été conçue pour étudier différentes approches pour améliorer l'accès et la qualité des services de césarienne en Tanzanie mal desservie et traduire les preuves en pratique. En 2016, 42 cliniciens associés de cinq centres de santé ont été formés en équipes pendant trois mois aux soins obstétricaux et néonatals d'urgence complets et à l'anesthésie suivis d'une supervision et d'un mentorat post-formation. De 2016 à 2019, 2 179 césariennes ont été réalisées dans les centres de santé d'intervention et 969 dans les centres de santé témoins. Les taux de césariennes dans la population desservie ont augmenté de manière significative dans les cinq centres de santé d'intervention et étaient supérieurs à 10 % dans trois établissements. Le risque qu'une femme meure des complications d'une césarienne dans les centres de santé d'intervention était de 2,3 pour 1 000 césariennes (IC à 95 % 0,7 - 5,3). Ce programme éducatif a été adopté par le gouvernement et peut être utilisé pour répondre à la demande de services de césarienne dans d'autres régions mal desservies d'Afriqu

Feasibility and safety of a 6-month exercise program to increase bone and muscle strength in children with juvenile idiopathic arthritis

Background: Arthritis in childhood can be associated with muscle weakness around affected joints, low bone mass and low bone strength. Exercise is recognized as an important part of management of children with juvenile idiopathic arthritis (JIA) but the exercise prescription to best promote bone and muscle health is unknown. We therefore aimed to: 1. assess feasibility and safety of a 6-month home- and group-based exercise program for children with JIA; 2. estimate the effect of program participation on bone mass and strength, muscle function and clinical outcomes and 3. determine if any positive changes in bone and muscle outcomes are maintained 6 months later. Methods: We recruited 24 children with JIA who were part of the Linking Exercise, Physical Activity and Pathophysiology in Childhood Arthritis (LEAP) study to participate in a 6-month home-based exercise program involving jumping and handgrip exercises, resistance training and one group exercise session per month. We assessed lumbar spine bone mass (dual energy X-ray absorptiometry), distal tibia and radius bone microarchitecture and strength (high-resolution peripheral quantitative computed tomography), muscle function (jumping mechanography, dynamometry) and clinical outcomes (joint assessment, function, health-related quality of life) at baseline, 6- and 12-months. Adherence was assessed using weekly activity logs. Results: Thirteen children completed the 6-month intervention. Participants reported 9 adverse events and post-exercise pain was rare (0.4%). Fatigue improved, but there were no other sustained improvements in muscle, bone or clinical outcomes. Adherence to the exercise program was low (47%) and decreased over time. Conclusion: Children with JIA safely participated in a home-based exercise program designed to enhance muscle and bone strength. Fatigue improved, which may in turn facilitate physical activity participation. Prescribed exercise posed adherence challenges and efforts are needed to address facilitators and barriers to participation in and adherence to exercise programs among children with JIA. Trial registration: Data of the children with JIA are from the LEAP study (Canadian Institutes of Health Research (CIHR; GRANT# 107535). http://www.leapjia.com/

Assessment of an application on a detoxification process of groundnut press cake for aflatoxins by ammoniation

12 p.-2 fig.-2 tab.Following a request from the European Commission, the EFSA Panel on Contaminants in the Food Chain (CONTAM) provided a scientific opinion on an application for a detoxification process of groundnut press cake for aflatoxins by ammoniation. Specifically, it is required that the feed decontamination process is compliant with the acceptability criteria specified in the Commission Regulation (EU) 2015/786 of 19 May 2015. The CONTAM Panel assessed the data provided by the feed business operator with respect to the efficacy of the process to remove the contaminant from groundnut press cake batches and on information demonstrating that the process does not adversely affect the characteristics and the nature of the product. Although according to the literature the process may be able to reduce aflatoxin levels below the legal limits, the Panel concluded that the proposed decontamination process, on the basis of the experimental data submitted by the feed business operator, cannot be confirmed for compliance with the acceptability criteria provided for in Commission Regulation (EU) 2015/786 of 19 May 2015. The Panel recommended sufficient sample testing before and after the process, under the selected conditions, to ensure that the process is reproducible and reliable and to demonstrate that the detoxification is not reversible. In addition, genotoxicity testing of extracts of the treated feedingstuff and of the identified degradation products would be necessary. Finally, information on the transfer rate of AFB1 to AFM1 excretion in milk for animals fed the ammoniated product, in comparison to the starting material and on the ammoniation process changes of the nutritional values of the feed material should be provided.The Panel wishes to thank Federico Cruciani and Carina Wenger for the support provided to this scientific output, and the hearing expert Professor Dr Wayne L Bryden, for the overview on aflatoxin inactivation by ammoniation.Peer reviewe

Risk assessment of chlorinated paraffins in feed and food

The Panel wishes to thank the hearing expert: Kerstin Krätschmer and EFSA staff member: Kelly Niermans for the support provided to this scientific output. The CONTAM Panel acknowledges all European competent institutions and other stakeholders that provided occurrence data in food and human milk and data on the toxicity of CPs, and supported the data collection for the Comprehensive European Food Consumption Database.Peer reviewedPublisher PD

Evaluation of the shucking of certain species of scallops contaminated with domoic acid with a view to the production of edible parts meeting the safety requirements foreseen in the Union legislation

Acknowledgements: The Panel wishes to thank the following hearing experts for the support provided to this scientific output: Marina Nicolas and Micheal O'Mahony. The Panel wishes to acknowledge all European competent institutions, Member State bodies and other organisations that provided data for this scientific output.Peer reviewedPublisher PD

Update of the risk assessment of hexabromocyclododecanes (HBCDDs) in food

Panel members: Margherita Bignami, Laurent Bodin, James Kevin Chipman, Jesus del Mazo, BettinaGrasl-Kraupp, Christer Hogstrand, Laurentius (Ron) Hoogenboom, Jean-Charles Leblanc, Carlo StefanoNebbia, Elsa Nielsen, Evangelia Ntzani, Annette Petersen, Salomon Sand, Dieter Schrenk, TanjaSchwerdtle, Christiane Vleminckx and Heather Wallace Requestor: European Commission Question number: EFSA‐Q‐2018‐00433 Acknowledgements: The Panel wishes to thank the hearing experts: Cathy Fernandes and Henri Schroeder, and EFSA staff members: Kelly Niermans and Federico Cruciani, for the support provided to this scientific output. The Panel wishes to acknowledge all European competent institutions and Member State bodies that provided consumption and occurrence data for this scientific output. Data: All annexes on occurrence and exposure data, as well as the protocol used to produce this Scientific opinion, cross‐referenced in the text, are available on the EFSA Knowledge Junction at: https://doi.org/10.5281/zenodo.4475651Peer reviewedPublisher PD

Evaluation of the shucking of certain species of scallops contaminated with lipophilic toxins with a view to the production of edible parts meeting the safety requirements foreseen in the Union legislation

Acknowledgements: The Panel wishes to thank the following hearing experts for the supportprovided to this scientic output: Laurent Guillier, Mari na Nicolas and Micheal O’Mahony. ThePanel wishes to acknowledge all European competent institutions, Member State bodies and otherorganisations that provided data for this scientic outputPeer reviewedPublisher PD

Risk assessment of aflatoxins in food

© 2020 European Food Safety Authority. EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority.Peer reviewedPublisher PD